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My Dog Won't Stop Drinking Water and Peeing — Cushing's vs Diabetes

A 9-year-old Miniature Schnauzer with PU/PD, pot-bellied appearance, and thinning skin. Differentiating Cushing's syndrome from diabetes mellitus.

9 min read2026-01-09
dog drinking too muchCushing's diseasediabetesPU/PD
PetMed AI Veterinary TeamVerified

Reviewed by Licensed DVM Professionals

Evidence-BasedPeer-Reviewed SourcesLast updated: 2026-01-09
Case Presentation

Your 9-year-old Miniature Schnauzer, Max, has been drinking and urinating excessively for weeks. His belly looks distended, his coat is thinning, and he seems lethargic. He's always at the water bowl. Could it be Cushing's or diabetes?

9 yr
Age
Mini Schnauzer
Breed
PU/PD
Signs
Pot-belly
Classic

🩺 Differentials: Diabetes vs Cushing's

Both cause PU/PD. Diabetes mellitus causes hyperglycemia and glucosuria; fasting glucose is elevated. Cushing's syndrome (hyperadrenocorticism) causes elevated ALP, cholesterol, and often a stress leukogram. The Bloodwork OCR helps interpret chemistry panels. The Internal Medicine Specialist walks through the workup: check glucose first—if elevated, diabetes is likely. If glucose is normal but ALP is high, consider Cushing's.

🔬 Cushing's Testing

ACTH stimulation test or low-dose dexamethasone suppression (LDDS) confirms Cushing's. The Endocrinology Specialist explains interpretation. Pituitary-dependent (PDH) is most common; adrenal tumors are less common. Treatment options include trilostane or mitotane. Miniature Schnauzers are predisposed to both diabetes and Cushing's.

📋 Key Clinical Signs

Cushing's: pot-belly, thin skin, hair loss, panting, muscle wasting. Diabetes: weight loss despite appetite, cataracts (dogs), ketones in urine (DKA). The Bloodwork OCR can help you understand ALP elevation and glucose curves.

Use Bloodwork OCR, Internal Medicine Specialist, and Endocrinology Specialist for lab interpretation and differential discussion.


Key Takeaways
  • PU/PD = polydipsia/polyuria—both diabetes and Cushing's cause it.
  • Fasting glucose first—elevated = diabetes workup.
  • Elevated ALP + pot-belly = Cushing's workup (ACTH stim, LDDS).
  • Miniature Schnauzers are predisposed to both conditions.
  • Treatment differs—insulin for diabetes, trilostane for Cushing's.

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